| NPI | 1649692385 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHARLES E. RUCKEL Doctor/Owner 260-432-5354 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IN 08000913A) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |